Fighting for the Body She Was Born With

Dutee Chand loves her body just the way it is. She loves her long, dark hair, which is often pulled back into a tight ponytail, and the toned biceps she likes to show off with tank tops. As a young teenager, she was dismayed that her body lacked curves, but now, at 18, she loves that, too. She believes that the body she was born with — every chromosome, cell and organ — makes her the woman she is.

But to compete internationally as a female sprinter, that is not enough.

Last summer, Chand, India’s 100-meter champion in the 18-and-under category, was barred from competing against women. She has a condition called hyperandrogenism, and her body produces natural levels of testosterone so high that they place her in the male range in the eyes of international track and field.

Following a rule by the International Association of Athletics Federations, track’s governing body, the Athletics Federation of India will allow Chand to return to competition only if she lowers her testosterone level beneath the male range. She can do that by either taking hormone-suppressing drugs or having surgery to limit how much testosterone her body produces.

Her response? No way.

“I feel that it’s wrong to have to change your body for sport participation,” she said last month, in Hindi, through an interpreter. “I’m not changing for anyone.”

In a landmark move, Chand is fighting her ban. Last month, she filed an appeal with the Court of Arbitration for Sport in Switzerland, challenging guidelines put in place in 2011 by the I.A.A.F. The International Olympic Committee has a similar rule that stipulates the organization’s criteria for determining eligibility to participate in women’s competitions.

But Chand’s case is potentially more troubling than those of Rehm and Pistorius because she is competing with the body she was born with, a purity the I.A.A.F. rule says is not allowed in her case. Aside from hormone-suppressing drugs or an operation, her alternative is to hang up her spikes.

“It’s like in some societies, they used to cut off the hand of people caught stealing,” Chand said of the idea of medically altering her body. “I feel like this is the same kind of primitive, unethical rule. It goes too far.”

It has taken a lot of courage for Chand to stand up for herself; other athletes with her condition have quietly consented to surgery or left sports altogether. But Chand says she is willing to handle the scrutiny that has come with her public stand.

“I cried for three straight days after reading what people were saying about me,” she said, regarding what she saw being debated in Internet forums. “They were saying, ‘Dutee: Boy or girl?’ and I thought, how can you say those things? I have always been a girl.”

Chand’s situation has highlighted one of the most perplexing issues facing sports and society: that there is no indisputable way to draw a line between male and female when most competitions have only two categories — one for men and the other for women.

Olympic sports have chosen to set a limit on testosterone to distinguish the two. Unfortunately, that standard leaves a woman like Chand on the outside looking in.

“We’ve come up with an imperfect solution, but there’s no easy way around this,” said Eric Vilain, a medical geneticist at U.C.L.A. who helped create the I.O.C.’s hyperandrogenism policy. “The other solution is mixing genders for competitions, and that wouldn’t be fair to women because the women wouldn’t be given much chance of winning.”

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Chand, left, after taking the bronze medal in the women's 200 meters at the Asian Athletics Championship last year. Her compatriot Asha Roy took the silver.CreditManjunath Kiran/Agence France-Presse — Getty Images

Arne Ljungqvist, the longtime chairman of the I.O.C.’s medical commission, said a hyperandrogenism policy was necessary because Olympic sports have an overrepresentation of athletes with both male and female anatomical characteristics.

One recent study on women competing at the 2011 track and field world championships found that 7 in 1,000 elite track and field athletes had hyperandrogenism and some blend of male and female anatomical characteristics. That’s 140 times more than expected in the general population.

“People who say, ‘This is nothing; we don’t need this rule,’ don’t know sports or are at some distance from sport,” Ljungqvist said. “This is not an easy matter. It’s an evolving matter. We just can’t bury our heads in the sand and pretend these conditions do not exist.”

The I.O.C. chose testosterone as a way to differentiate men from women because it is known to increase strength and muscle mass, and to help bodies recover from workouts. Female athletes with high testosterone can still have levels well above the average range for women. They just need to be below what the I.O.C. deems as the men’s range.

The study from the 2011 world championships said testosterone levels for women in the 99th percentile were 3.08 nanomoles per liter, which is markedly lower — “extraordinarily lower,” according to Vilain — than the 10 nanomoles per liter which the I.A.A.F. has set as the lower end for the male range.

Chand’s testosterone tests above that lower limit for men. But her supporters say testosterone should not be used as a gauge, because there has been no scientific published proof that it alone conveys an athletic advantage, especially when that testosterone is naturally produced. Critics say it is impossible to provide such proof because giving athletes testosterone to study its effects would be unethical.

Chand has a simpler take.

“If you make an elephant run, can that elephant run fast, even though he has a lot of strength?” she said. “Not necessarily. It’s all about training.”

The case is likely to take months to decide. Chand will remain in limbo, worried that her childhood dream will permanently derail.

The daughter of weavers who make about $8 a week, Chand was about 4 when she started tagging along with her elder sister, one of her six siblings, for workouts on a local track. By the time she was 10, she was living three hours from home and training in a national program, thrilled that she could send her prize money to her family. With her financial help, her parents eventually moved out of their two-room, no-toilet mud hut into a four-room house.

She was an Olympic hopeful on India’s roster for the Commonwealth Games in July when she was pulled from the team at the last minute. Evidently, an official or a competitor at the Asian Junior Athletics Championships in June, where Chand had won two gold medals, had requested that she be tested for hyperandrogenism. The Sports Authority of India, at the request of the Athletics Federation of India, arranged for her to be given medical exams. Doctors poked and prodded her, took her blood, visually examined her naked body and sent her for a magnetic resonance imaging exam, so they could get a clear picture of her insides. Chand said she had no idea what they were looking for.

“I was made to understand that something wasn’t right in my body, and that it might keep me from playing sports,” she said.

Though her name was not made public by sports officials, it did not take a genius to figure out that the athlete dropped from India’s announced roster was Chand.

A newspaper reporter called Payoshni Mitra, a researcher and activist on gender and sports, for comment about the case. Mitra tracked down Chand’s contact information and took an eight-hour train ride to visit her and explain what was happening to her. Mitra urged Chand not to consent to drugs or surgery too soon, and suggested she appeal her case.

“The sports officials who make these rules have no idea who they are stopping from competing,” Mitra said. “Many of these women are providing for their families. Sports gave them so much, so many opportunities.”

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Payoshni Mitra, a researcher and activist on gender and sports, suggested that Chand appeal the ban that has kept her from competing.CreditGraham Crouch for The New York Times

She added, “They are crushing these women.”

Katrina Karkazis, a senior research scholar in bioethics at Stanford, has been working with Mitra on Chand’s case. Together with other supporters of Chand, they persuaded the Sports Authority of India to back Chand’s appeal. Most important, they have probably spared Chand untold pain.

Others have not been as fortunate. Four female athletes at the 2012 London Olympics were flagged by the high testosterone rule. Those athletes, who were 18 to 21 and from rural regions in developing countries, were whisked to a clinic in France for evaluations. All were found to have a mix of male and female anatomical features and ended up having surgery to remove their testes, which they were told would lower their testosterone levels and allow them to continue competing.

A study published last year revealed the cases and reported that those athletes also had medical procedures that had nothing to do with lowering their testosterone levels for sports: a reduction to the size of their clitorises, feminizing plastic surgery and estrogen replacement therapy.

“We don’t know what was said to these women, maybe, ‘Do all of this or lose your career,’ ” Karkazis said. “Or was it even more horrific, like, ‘You’re not a woman until you have all of this done.’ ”

She added, “At least this time we got to the athlete before any interventions were done, and we’ve spared one person from that colonial mentality.”

Ljungqvist said he was shocked to hear of the cases because surgical intervention is not in the hyperandrogenism policy rules. He said he was confident that the rules were sound, but deemed the way they were applied in those cases “unacceptable.”

That is why all sides should welcome a hearing conducted by an independent body like the Court of Arbitration for Sport: The issue is so confusing, and more cases like Chand’s are inevitable.

At the very least, the hyperandrogenism policy will be debated openly in court, before other athletes find themselves entangled in the rule and its potentially agonizing consequences.

But the court also needs to determine if there is a place for athletes like Chand in Olympic sports.

And whatever the answer is, can it ever be fair?

Chand is not concerned with the politics of it all. Her coaches back home have been encouraging her to agree to have surgery so that she can return to competition. She says she always answers: “Why surgery? I’m not sick!”

She said she was drawn to athletic competition because it offered a good option to getting married and having a family.

“When girls play a sport, they are treated equally, so society becomes more equal,” she said. “I really liked that.”

If her appeal to the sports arbitration court is rejected, Chand will pursue coaching, she said, because she loves the sport so much. But she is not giving up yet. Two weeks ago, Mitra showed Chand the documentary “Too Fast to Be a Woman?” about Semenya. Chand was overwhelmed with emotions.

“Look, I’m not alone,” she said. “There are other people like me.”

Email: juliet@nytimes.com

A version of this article appears in print on , on Page B11 of the New York edition with the headline: Fighting for the Body She Was Born With. Order Reprints | Today’s Paper | Subscribe